Breast Cancer, Sexuality & Intimacy – Part II Let’s Talk About Sex…

Posted on April 5, 2016

Why is it so difficult to talk about sex? This topic seems to be one of the last taboo subjects left in our culture. Even though we are completely inundated with sexual material in the media all day long, it is still fairly taboo to speak about sex with your partner, friends, and even your healthcare providers.

There can be many real, physical and psychological complications for women with breast cancer, such as lower sexual desire and arousal, poor body image, discomfort and pain during intercourse. One of the most difficult struggles for many couples seems to be communication about all these complications and how they affect intimacy and connection. Don’t get me wrong, these very real mind and body issues are happening for many people living with breast cancer and survivors. My point is that these issues are often held inside and not expressed or openly shared with partners.

Many women find it hard to talk about sex in general and have for their whole life. They do not want to bring up the topic and share what is going on for them. For some women, internal shame holds them back and for others there may be a fear of being judged. Additionally, after treatment, many women reflect on how vulnerable they felt throughout the process of diagnosis and treatment. They just want some semblance of “normal” back in their lives, and do not want to feel vulnerable all over again by talking about sex and all the differences they may be experiencing.

Many men do not know how to approach the subject of sex with their partner in part because they do not want appear as though they are pressuring them or for fear of complaining and/or being selfish. Both partners, no matter the gender, probably did not receive much positive role modeling with regard to how to talk about sex, intimacy, or general feelings.

Many human beings feel a sense of shame around sex based on message from their upbringing. Think about the messages you were given about sex growing up. What were you taught, both verbally and non-verbally? Did you actually receive “the talk” from a parents or loved one? For some that did not get “the talk,” took away a message that sex was dirty and wrong and should not be talked about aloud. Some received a message that they should not get pregnant and that was it, without much or no education. Meaning, they were not taught about pleasure or connection or all the amazing and wonderful aspects of sex. Sex was just bad because it could get you into trouble. The majority of people I talk to learned about the mechanics of sex through porn. What kind of messages are sent through pornography as a learning tool or the fact this is ones sole source of sex education? Some will feel ashamed, while others incorrectly feel these messages are truth or real.

Intimacy, including but not limited to sex, is important for couples’ connection and bonding and needs to be discussed as part of the recovery process. Breast cancer can be a real impetus to having a more open and honest dialogue about sex and intimacy, and can actually greatly improve some couples’ sex lives.

Here are a few basic things to keep in mind when attempting to discuss sex/intimacy (or really most anything) with a partner:

Schedule a time to talk when you both have time and are not rushing to work or a meeting. Once you have had the discussion, schedule another time to talk about it again soon, so you do not lose your momentum.

Start the conversation by reminding yourself and your partner that this might be an awkward discussion. It is always a good reminder and can help break the ice and make the conversation lighter from the beginning.

Be clear and state what the problem is for you. This may take some planning to determine what you believe the problem to be and how you can be open, honest, and constructive in the discussion. Try not to dance around the main topic; be direct.

Use “I” statements. It is important that you share about your own experience and not speak for your partner. Tell your partner how you feel about your sex life. This way you are not blaming the other person or putting words in their mouth.

Do not read your partner. Try to ask more questions and verify what your partner means when you might be interpreting things in a negative way. Sometimes we all hear things that are not being said and need some verification or reassurance. For example: Your partner says something like, “I do not have a desire to have sex anymore.” You might hear this, “I do not love you or find you attractive anymore.” Rather than assuming this is what they meant to say, ask them for clarification and remain open to discussing it. We all hear things that are not actually said at times, especially when emotional states and stakes are high.

Assume good intentions. If your partner cares enough to be bringing this up, they probably mean well, but do not know how to talk about sex very well. In this culture, many of us do not get all that much practice. Try your best to give your partner the benefit of the doubt.

Listen. When your partner is sharing, make an effort to whole-heartedly listen to them. We are often thinking about what we want to say next. Sometimes we experience a parallel thought process, so when our partner is talking, we are thinking about all the things we need to do after this conversation is over. Make a real effort to stay present with your partner and listen.

Get help. If you try all the above steps several times and these discussions turn into fights and you do not feel closer afterward, you may want to look for help from a professional to help guide these difficult conversations.

I will be back with more about what kinds of things to discuss regarding sex and intimacy in this series about breast cancer, sexuality and intimacy.

Kimberly Atwood is a holistic psychotherapist working with individuals and couples in private practice in Princeton, New Jersey and Doylestown, Pennsylvania. She specializes in women’s sexual health, intimacy and relationship issues. For more information, please check out her website: kimatwood.com